Provider Demographics
NPI:1164964490
Name:RICHARDSON, KATIE DOSSEY (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:DOSSEY
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 TROTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4802
Mailing Address - Country:US
Mailing Address - Phone:931-982-4306
Mailing Address - Fax:931-540-4213
Practice Address - Street 1:1224 TROTWOOD AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-4802
Practice Address - Country:US
Practice Address - Phone:931-982-4306
Practice Address - Fax:931-540-4213
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3156133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered